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Nurse Consultant Utilization Review

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Claims
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39235 Requisition #
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At Gallagher Bassett Services, Inc. (GB) we are constantly seeking skilled professionals who are up for a challenge and take exceptional performance to heart. The professionals we hire help us maintain our reputation as one of the most progressive property/casualty third party claims service organizations in our industry and throughout the world.  Gallagher Bassett provides services to Fortune 1000 companies throughout 100 offices worldwide.  For the past several years GB has ranked among the largest TPA's by Business Insurance Magazine and was also a recipient of the Business Insurance Readers' Choice award for "Best Third Party Claims Administrator."  If you're looking for a professional career with an industry leader then you have come to the right place.  Wherever your interests lie, we're sure you will agree on one thing: our continued prosperity hinges on our greatest resource --- our people.
 
Position Summary:
 

Provides utilization management review of worker's compensation claims . Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required.

 

Essential Duties & Responsibilities:

  • Communicates with medical providers and ancillary service providers to negotiate or approve treatment.
  • Engages physician review agents as appropriate.
  • Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers, employers and employees.
  • Follows national and state guidelines for approval of treatment , medications, etc.

Additional Considerations:

 
Required:
  • Associate's degree from an accredited school of nursing and a minimum of 3 years acute clinical experience or similar position required.
  • Hold an active RN license within the state of practice.
  • Willing to be licensed in states requiring same for Utilization Review.

Desired:

  • Bachelor's degree.
  • Experience in Worker's Compensation or Utilization Review.

Work Traits:

  • Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice
  • Demonstrates good written and oral communications, organizational and leadership skills
  • Computer literate
  • Demonstrates good time management skills
  • Self starter
U.S. Eligibility Requirements:
  • Interested candidates must submit an application and resume/CV online to be considered
  • Must be 18 years of age or older
  • Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation
  • Must have unrestricted work authorization to work in the United States.  For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization
  • Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure

Gallagher offers competitive salaries and benefits, including: medical/dental/vision plans, life and accident insurance, 401(K), employee stock purchase plan, educational expense reimbursement, employee assistance program, flexible work hours (availability varies by office and job function) training programs, matching gift program, and more.  

 
Gallagher believes that all persons are entitled to equal employment opportunity and does not discriminate against nor favor any applicant because of race, color, religion, sex, age, veteran status, disability, national origin, or any other legally protected status.  Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination.  In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified applicant with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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